The effect of statin adherence on patients with type 2 diabetes after percutaneous coronary intervention for acute coronary syndrome

Purpose To investigate the effect of long-term statin adherence among patients with type 2 diabetes mellitus (T2DM) after percutaneous coronary intervention (PCI) for acute coronary syndrome. Main outcome measures All-cause readmission after initial PCI intervention was defined as the main outcome of the study. Readmission for revascularization, cerebrovascular disease, and so on among the study population was analyzed as secondary outcomes. Methods A total of 11,172 patients with T2DM who underwent PCI for ACS were selected from the Beijing Basic Medical Insurance Database for urban employees between January 1, 2014, and December 31, 2018. Patients' long-term adherence to statin utilization was investigated during a 3-year follow-up period through survival analysis after adjusting for covariates, including outpatient medications for secondary prevention of coronary heart disease and other complications. Results Among patients, 29.7% showed a high level of adherence in terms of statin utilization after 3 years of follow-up. High statin utilization adherence was associated with a reduction in all-cause hospitalization rates compared to those with low levels of adherence (62.72% vs. 68.18%; HR, 0.85 [95% CI, 0.80-0.90], P < 0.0001). For secondary outcomes, a high level of statin adherence showed a protective effect as well: readmission rate for revascularization (49.56% vs. 53.96%, HR, 0.87 [95% CI, 0.82-0.93], P < 0.0001), readmission rate for cerebrovascular disease (6.78% vs. 10.17%, HR, 0.65 [95% CI, 0.55-0.76], P < 0.0001), and diabetes-related readmissionrate (11.05% vs. 14.81%, HR, 0.69 [95% CI, 0.61-0.79], P < 0.0001). Conclusion In Beijing, long-term statin adherence among patients with T2DM after PCI is still not high, and the incidence of all-cause readmission, revascularization and cerebrovascular disease may be reduced through improving statin adherence.